• Open Access

Costs of being a carer: labour force participation and lost earnings among older working-aged Australians


Correspondence to: Professor Deborah Schofield, NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Locked Bag 77, Camperdown, NSW 1450; e-mail: deborah.schofield@ctc.usyd.edu.au

The demand for care for disabled, ill and elderly people is projected to grow significantly1–4 around the world. This care can be provided in both formal and informal settings: formally by people employed in the health care sector and informally by relatives or friends. Informal carers are generally not paid for their caring responsibilities, but these responsibilities can have an impact on the capacity of the carer to undertake paid employment.5 We have examined the association between being a carer and labour force participation for those aged 45 years and over, and analysed the effect of being a carer on their household income. We undertook a cross-sectional analysis of the baseline data of the 45 and Up Study participants6 aged 45 to 64 years.

Of the 265,515 people surveyed, excluding those who independently volunteered to participate in the study, 162,590 (43.1% males) were aged between 45 and 64 years. Among them, 7.8% of men and 14.3% of women reported regularly caring for a sick or disabled person. The likelihood of becoming a regular carer increased with age. Of regular carers, 34.9% either reported that they were full-time carers or spending 35 or more hours per week for caring.

Full-time carers were less likely to be working full-time and more likely to be out of the labour force than non-carers. Although part-time carers were also less likely to be in full-time work and more likely to be not working than non-carers, the differences were not as large as the differences between full-time and part-time carers (with 77.5% of part-time carers working full time and 8.1% not working, versus 41.9% of full-time carers working full time and 39.4% not working). Women were more likely to be either in part-time work or not working, compared to men of the same age group.

Both part-time and full-time carers were less likely to be employed full time than non-carers. The male part time carers were significantly less likely to be in full time employment (OR 0.79, 95% CI 0.70–0.88) than non-carers. The odds of being in full-time employment were even lower for full-time carers (OR 0.15, 95% CI 0.13–0.18). Similar results were found for females. Part-time carers were more likely to be in part-time employment than non-carers – statistically significant for females (OR 1.10, 95% CI 1.03–1.18) but not for males.

When full-time carers reported a fair or poor health status, they had an even lower chance of being in full-time employment or part-time employment. Male full-time carers who had poor health status only had 0.06 (95% CI 0.04–0.07) times the odds of being in full-time employment and 0.17 (95% CI 0.13–0.23) times the odds of being in part-time employment of the non-carers who had excellent health status. For female full-time carers who also had poor health status, the odds of being in full-time and part-time employment were respectively 0.07 (95% CI 0.06–0.09) and 0.15 (95% CI 0.12–0.18) times the odds for female non-carers who had excellent health status.

Full-time carers were likely to have lower household income than non-carers. Among those married or living with a partner, 27.2% of full-time carers had an annual household income of less than $20,000, compared to only 7.1% of non-carers. By contrast, 41% of non-carers had an annual household income of greater than $70,000, whereas only 12.6% of full-time carers had this level of household income.

Being a full-time or part-time carer significantly reduces an individual's labour force participation rate relative to their peers. These results are consistent with other studies that have found that carers generally have lower rates of labour force participation, both within Australia and internationally.7–13 The effort of the individuals who give up their own time and their own employment to provide care for another should be recognised for the vital service they provide to society. The significant costs as a result of informal care to both individuals and governments also need to be recognised.


This study was supported by the Study of Economic and Environmental Factors in health (SEEF) project funded by the National Health and Medical Research Council Preventive Healthcare and Strengthening Australia's Social and Economic Fabric Strategic Award. We thank all the 45 and Up Study participants and The Sax Institute for providing the data. The 45 and Up Study is managed by the Sax Institute in collaboration with major partner Cancer Council NSW, and other partners: the NSW Division of the National Heart Foundation of Australia; the NSW Department of Health; beyondblue: the national depression initiative; Ageing, Disability and Home Care, NSW Department of Human Services; and UnitingCare Ageing.